6 replies to this topic

[Crepulance]

Hi all, it's been a while since I've been on.
What does anyone know regarding new techniques/scans that can accuratel assess arterial plaque without radiation danger.

Something similar to a calcium CT, but without the radiation.

I know they have some type of nano iron particle mri scan that's new, but that's for other detections.
Anyone?

[YOLF]

There is a branch of sonography called cardiovascular sonography. You could look into that.

[Richard McGee]

I've seen the Carotid Ultrasound and the Ankle Brachial Index (ABI) offered as service with no prescription or referral required (~ $50 each). They would both seem to give some kind of indication of atherosclerosis. My question is do these tests yield quantitative scores that would enable one to accurately measure progress in reversing atherosclerosis. Is anybody familiar with these tests?

Edited by Richard McGee, 16 November 2016 - 06:01 PM.

[pamojja]

I've seen the Carotid Ultrasound and the Ankle Brachial Index (ABI) offered as service with no prescription or referral required (~ $50 each). They would both seem to give some kind of indication of atherosclerosis. My question is do these tests yield quantitative scores that would enable one to accurately measure progress in reversing atherosclerosis. Is anybody familiar with these tests?

 

With a PAD due to 80% stenosis at my abdominal aorta bifurcation and only 3-400 pain-free walking distance at the time of diagnosis, have some experience with ABI (> 0.9 normal range), and less with CIMT (< 0,9).

 

ABI - max. pain-free walking distance (year)

0.7 - 0.4 km (2008)

0.5 - 8 km (2011)

0.8 - 4 km (2012; at the beginning of a chronic bronchitis lasting 1 year, shortly after increasing to 8 km again)

0.7 - 3 km (2014; shortly after improving to a point, where I don't get the specific to PAD leg-pains anymore, lasting till today)

 

CIMT -  year

0.13 - 2012, beginning of the year; only can guess the coma was placed at the wrong place..

1.3 - 2012 end of year

1.9 - 2014

Beginning of December will have the next ABI and CIMT evaluation.

 

Through my experiences I don't consider such soft-tissue measurements very accurate. Any random factor at the day of measurement could cause too much contraction/expansion of tissues. Or the testing person's variating diligence in finding the same spot of 'maximal' carotid intimal thickness. Or the spot last time tested isn't accessible the next. In fact, last time my stenosis couldn't be measured due to flatulence ..hilarious, what just a fart can do to these measurements..

 

 

PS: Even my 80% stenosis is little more than a guess. The first time my record read it was up to 80% blockage, the second time the same MD 2 years later reported: vastly progressed with at least 70% blockage; the third time I payed closer attention to what he actually measured: it was the frozen picture at the time of contraction of the aorta. But the MD ignored my suggestion to get at least the mean between contracted and expanded aorta..

 

A second MRI - though not more quantitative - would be interesting to see though:

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Edited by pamojja, 16 November 2016 - 07:56 PM.

[Richard McGee]

It's a shame. I want to try different dietary and supplement regimes to (possibly) reverse my atherosclerosis, but I do hate flying blind. There's some encouraging work in standardizing the results of these tests:

 

"New quantitative methods beyond backscatter (to include speed of sound, attenuation, strain, temperature, and high order statistics) will be developed to evaluate vascular tissues. These image methods may offer opportunities for the early detection and treatment of the disease [52]. Once the methodology and analysis have been standardized, the stage will be set for future prospective randomized trials to evaluate whether quantitative tissue characterization-based information on plaque vulnerability can be used to tailor risk and treatment in patients with clinically symptomatic and high-risk asymptomatic atherosclerosis."

 

https://www.ncbi.nlm...les/PMC4463636/

[pamojja]

It's a shame. I want to try different dietary and supplement regimes to (possibly) reverse my atherosclerosis, but I do hate flying blind. There's some encouraging work in standardizing the results of these tests:

 

 ..These image methods may offer opportunities for the early detection and treatment of the disease [52].

 

For that a repeated coronary calcium score is the best available mean. ABI and CIMT are valuable in that they indeed offer 'early detection' before any symptoms develop. About the 'treatment' I'm not at all sure. Refused everything offered (except regular testing) from conventional medicine. Since even the diagnosing MD was of the opinion, that what ever I do, this disease will mercilessly progress. And however much greens I would eat beside standard of care, 5-year mortality would remain at 30%. Utterly ignorant.

[Richard McGee]

If calcium scoring is the best way to go, then you just need to make sure you have a low-radiation CT machine, following the correct protocols.

 

https://www.ncbi.nlm...les/PMC4789203/

 

"While CAC scoring may further refine the risk categorization of patients, radiation exposure was one of the cited reasons that the updated 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk downgraded CAC scoring from a class IIA recommendation in the 2010 ACC/AHA guidelines to a class IIB recommendation in asymptomatic, intermediate risk patients for whom the decision to treat based on risk is uncertain after formal risk estimation [9]. However, recent advances in radiation dose reduction for CAC scoring may enable a re-examination of these concerns...

 

...In conclusion, we now have an increasing body of evidence on multiple platforms that CAC scoring at sub-mSv radiation doses can be performed reliably, particularly through the use of iterative reconstruction."

 

So ask about low dose radiation and iterative reconstruction, if you go the CT route.

Edited by Richard McGee, 17 November 2016 - 02:31 AM.